Outback, but in demand

Working in remote areas has some disadvantages but one of the big pluses is being a valued member of a community. By Linda Belardi

Sue Stewart had only planned to stay for six months at Bidyadanga clinic in Western Australia’s largest remote community. But five years later, the former dialysis nurse from Victoria is now the clinic’s manager and a strong fixture in the 1000-strong Aboriginal community.

Managing a team of four remote area nurses and four Aboriginal health workers, Stewart says she enjoys the variety and independence of remote area nursing.

The community clinic 200 kilometres south of Broome treats a high rate of acute and chronic illness, including diabetes and renal disease, interspersed with local emergencies.

Situated 13 kilometres off the northern highway, road accidents are an especially traumatic event for the nurses who provide a 24-hour on-call service.

RFDS doctors fly into the community twice a week, supplementing the presence of a full-time GP, while daily busloads of patients are transported to Broome for specialist appointments. The clinic currently operates with standing orders and emergency cases are evacuated to Broome either by ambulance or plane.

When working in a remote area, Stewart says nurses require the resilience to be able to cope with whatever is thrown at them, including staff shortages and mental health emergencies. “I love the fact that you don’t know what will come through the door each day. You would never get bored working as a remote area nurse.”

Bidyadanga Community Clinic, which was established in 1986, is managed by the Kimberley Aboriginal Medical Services Council, a regional Aboriginal Community Controlled Health Service.
Located on the Kimberley coast, Bidyadanga is home to five indigenous language groups and the recognised traditional owners of the land are the Karajarri people.

Like all remote communities, a shortage of housing and accommodation is a significant issue and can pose a particular problem for relief nurses and allied health providers wishing to temporarily stay in the community. The issue also acts as a community deterrent to apply for health grants to fund more screening and specialist programs if the necessary staff cannot be accommodated.

Despite initial difficulties accessing quality mobile phone and internet coverage, technology has proven to be a critical part of the daily practices of the clinic.

For three years, the clinic has been utilising an electronic patient database, which can be accessed by the on-call GPs in Broome during the evening and on weekends. Telehealth consultations have all been used to link up with ear, nose and throat specialists for patient consultations. “We can be looking in the patient’s ears and the specialist can see it in Perth at the same time,” Stewart says.

Her ongoing priority is community disease prevention and conducting annual health checks across all age groups. “If we can identify risk factors and act on them early, hopefully we will decrease the incidence and the severity of chronic disease.”

She says she would also like to improve community access to mammogram screening through a visiting mobile truck. At the moment, the bus only stops at Broome.

However, she says there are no simple solutions to the huge and complex challenge of alcohol and drug use amongst the young population. For an hour every morning, one of Stewart’s nurses visits the community’s only school. A school health nurse also visits the Aboriginal community fortnightly but behaviour change will not be easy, she says.

After more than five years living in Bidyadanga, Stewart says she values the acceptance and trust she has earned from the community. “There are so many nurses that come and go in remote communities. It can be very hard for the locals as well. They tend not to get too close to the nurses.

“We came to Bidyadanga for six months with a view to going to some other communities around Australia, but we have just fallen in love the place and the people here. It is nice to be somewhere where everyone knows you and you feel a sense of belonging.”

This year, Rural Workforce Agencies have expanded their services to nursing and allied health as part of a Health Workforce Australia program to recruit more nurses to remote Australia.

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